• Implemented 12/1/98. Currently under short-term extension through 6/30/2005.
• Title IV-E funds are used to provide individually targeted, community-based, strength-based flexible services to children and families.
• 5 counties are testing Wraparound Services to help children and adolescents with complex and enduring needs whose out-of-home placements often fail.
• 2 counties are implementing Family Group Decision Meetings to involve families in decision making, ensure family strengths are taken into account during the case planning process, and to improve families’ decision-making skills.

Title IV-E eligible children: (1) at risk of placement; or (2) currently in out-of-home placement and moving toward family reunification, adoption or guardianship; or (3) who would remain in care or move to a higher level of care without intensive services.

Implemented in Alameda, Fresno, Humboldt, Riverside, Los Angeles, Sacramento, and San Luis Obispo Counties.

• Final evaluation report received 9/16/04.
• Random assignment design. Children assigned to experimental and control groups at a 5:3 ratio.
• Original sample of 1,666 children in experimental group and 999 in control group. State reduced sample size due to failure to implement or early termination by some counties.
• 664 children enrolled in the demonstration (including both the FGDM and Wraparound service components), with 421 children in experimental group and 243 in control group.

Wraparound Services :

• Implementation challenges included inadequate staffing and contextual challenges such as families’ socio-economic issues (e.g., intergenerational substance abuse, poverty and under-employment) and gaps in community resources (e.g., inadequate number of foster homes, lack of rural services, and high unemployment).
• No statistically significant differences between experimental and control groups in permanency rates or maltreatment recurrence.
• Some positive changes observed in caregivers’ reports of children’s health status, and in children’s emotional well-being. These differences were not statistically significant.

Family Conferencing Mode (FGDM) :

• Major challenges included high staff turnover, recruiting new staff, and disbursing funds flexibly within the context of existing county fiscal structures.
• No statistically significant differences emerged between experimental and control groups in permanency rates, maltreatment recurrence, or child well-being.

• Implemented 10/02.
• Terminated early on 9/30/04 due to problems with maintaining cost neutrality.
• Participating counties had discretion to use title IV-E funds to serve families using a broad menu of existing and newly created services.
• Most common services included: (1) clothing allowances; (2) payments to foster care and independent living facilities; (3) school supplies; (4) medical care; and (5) housing and utility payments.
• Family Team Meetings were a major service component.

Title IV-E-eligible and non-eligible children ages 0-18: (1) involved in child welfare system in court custody; or (2) at risk of maltreatment or placement.

Parents, foster parents or potential foster parents, custodial relatives, siblings, and adoptive or potential adoptive parents of these children were also targeted.

Implemented in 8 counties located within 2 State regions.

• Final evaluation report expected in June 2005.
• Experimental design with random assignment to experimental and control groups at 1:1 ratio.
• 311 children in experimental group and 301 in control group as of 3/04.
• Implementation in first county in 04/01; all 8 counties phased in by 9/02.
• Range of services evolved and expanded as more was learned about the needs of children and families.
• As of March 2004, a larger proportion of experimental group families received assistance in almost all service categories. However, the State could not attribute these differences in service usage exclusively to the availability of flexible IV-E waiver dollars.
• Barriers to implementation included: (1) staff shortages in some demonstration counties; (2) introduction of new State data information system at the same time as the demonstration; (3) delays in obtaining approval for modification of State’s cost allocation plan; and (4) lower than expected title IV-E eligibility rates among targeted children.
• Demonstration terminated early due to problems with maintaining cost neutrality.

• Implemented 10/1/01.
• Family Support Services Teams (FSST) comprised of chemical addiction counselors, local child welfare agency staff, treatment providers, parent aides, and mentors.
• Three treatment options offered: (1) inpatient treatment for parents and their children; (2) intermediate care; and (3) intensive outpatient treatment.
• Services included: case management; individual, group, and family therapy; housing, employment, child care, and transportation assistance; and health care and family planning.

Mothers or other female primary caregivers with a child in out-of-home care or at risk of placement due to substance abuse.

Participating children were both title IV-E eligible and non-IV-E-eligible.

Implemented in Baltimore City and Prince George’s and Baltimore Counties.

• Interim evaluation report received 3/31/04.
• Random assignment design. Initial plan to assign 100 women to experimental group and 100 to control group.
• Demonstration terminated early (December 2002) due to:
  • Lack of enrollment. As of 9/02 the demonstration had only 9 women in the experimental group and 9 women in the control group;
  • Client ineligibility and/or confusion regarding eligibility requirements;
  • Underreporting of substance abuse at intake;
  • Caseworkers’ lack of training to identify substance abuse issues;
  • Caseworkers being overburdened with existing child protection issues;
  • Resistance by caseworkers to random assignment;
  • Confusion over responsibility for recruiting eligible parents.
• Changes to address barriers included: (1) more training for intake workers in identifying and confronting substance abuse; (2) extended project enrollment periods; and (3) expanded eligibility criteria.
• Changes in training and recruitment did not significantly affect program enrollment.
• No outcome findings were reported.

• Implemented 11/15/99. Currently operating under a short-term extension through 11/30/05.
• Licensed Alcohol and Drug Abuse Counselors (LADCs) work with child protection workers in an advisory and supportive capacity, using their clinical skills to provide training, assessment, treatment, and case management services.

As appropriate, LADCs:

• refer parents to counseling and treatment;
• assist with case planning;
• collaborate with State and county corrections departments;
• provide intensive substance abuse case management; and help link caregivers and children to supportive resources.

Families involved in child protection services with caretaker substance abuse as a major referral reason.

Participating children may be title IV-E eligible or non-IV-E eligible.

Implemented in 2 child protection district offices (Nashua & Manchester).

• Interim evaluation report submitted 9/12/03. Final evaluation report expected 7/31/05.
• Random assignment design.
• 435 families enrolled in the demonstration as of 4/03: 222 families in experimental group and 213 families in control group.
• Substance abuse assessment completed for 58% of family members as of 9/03.
• Barriers to implementation: (1) clients’ reluctance to give informed consent; (2) clients’ lack of readiness to acknowledge substance abuse problems; (3) high CPS caseloads; (4) staff turnover; (5) confusion regarding roles and responsibilities of caseworkers and substance abuse specialists; and (6) problems with tracking client data.
• No statistically significant differences to date between experimental and control groups in placement rates, placement duration, placement stability, or maltreatment recurrence.
• Although not statistically significant, available findings on child and parent well-being point in a positive direction:
• Interviews conducted using the Child Behavior Checklist (CBCL) indicated greater declines in problem behaviors in 7 of 8 categories for children in the experimental group compared to children in the control group.
• Experimental group parents are less likely to be receiving TANF at follow-up, more likely to be enrolled in an educational program, and more likely to be employed full-time than parents in the control group.